A revised final version of this paper appears in the 2nd issue of volume 90 of The Milbank Quarterly.
Justin Jagosh,1 Ann C. Macaulay,1 Pierre Pluye,1 Jon Salsberg,1 Paula L. Bush,1 Jim Henderson,1 Erin Sirett,1 Geoff Wong,2 Margaret Cargo,3 Carol P. Herbert,4 Sarena D. Seifer,5 Lawrence W. Green,6 and Trish Greenhalgh2
1Participatory Research at McGill, Department of Family Medicine, McGill University; 2 Centre for Primary Care and Public Health, Barts and London School of Medicine and Dentistry; 3 Social Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, University of South Australia; 4 Centre for Studies in Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario; 5Community-Campus Partnerships for Health; 6University of California at San Francisco
The Milbank Quarterly, Vol. 90, No. 2, 2012 | © 2012 Milbank Memorial Fund. [Blackwell Publishing]
Context: Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by, and/or responsible for action on, the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes.
Methods: Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis.
Findings: From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context.
Key Words: Participatory research, action research realist review, systematic review, partnership synergy theory, community-based participatory research
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[Accepted manuscript. A revised final version of this paper appears in the 2nd issue of volume 90 of The Milbank Quarterly]